Provider Demographics
NPI:1114990348
Name:SYRES, KIMBERLY MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MARIE
Last Name:SYRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-4518
Mailing Address - Fax:585-336-5113
Practice Address - Street 1:1415 PORTLAND AVE STE 245
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3022
Practice Address - Country:US
Practice Address - Phone:585-922-4518
Practice Address - Fax:585-922-3950
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361433092086S0102X
NY3069112086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care